A RANDOMIZED TRIAL TO ASSESS COMPLEX PROCEDURAL SKILLS EFFECTIVENESS LEARNT THROUGH SIMULATION AND HANDS-ON JOB WITH PATIENTS

Objective: We aimed to compare and contrast the learning procedural skills effectiveness on patients against simulations (models & dummies).

Methods: We included 74 interns from Gynecology & Obstetrics Department (Services Hospital, Lahore) from October 2016 to November 2017. We identified five basic procedural skills including cervical (Pap) smear taking, manual vacuum aspiration, intrauterine contraceptive tool insertion, suturing and making of an episiotomy and management of the 3^rd stage labour. Two random groups were made having 38 interns in Group – I and the remaining 36 interns in Group – II. Four weeks of training of five procedural skills was carried out in Group – I on dummies and models; whereas, Group – II was given initial training on the patients. In the presence of standard checklist, identical objectives were achieved in both the groups on model and patients.

Results: After the four weeks evaluation no significant variation was observed in outcomes of both the groups. However, at the end point of training better outputs were received by Group – I than Group – II with respective scores of (86.7 ± 2.7) against (80.4 ± 4.8) with significant P-value of (< 0.001). Variation was more marked in the procedural skills of intrauterine contraceptive tool insertion, suturing and making an episiotomy and third stage labour active management.

Conclusion: Outcomes clearly speak for the development of skills on dummies and models before patients, which can be employed in the training of healthcare workers for the development of their procedural skills and effective performance of complex procedures. Outcomes suggest and favour the initiation of skill development programs through dummies and simulations and after that practical hands-on job with patients.

Keywords: Simulation, Procedural Skills, Mannequins, Dummies, Models and Assessment